Lewallen R P, Johnson E W
Mayo Clin Proc. 1981 Jan;56(1):22-6.
A retrospective study of patients who sustained a fracture of the amputation stump was carried out to determine how these injuries might be prevented and to develop an optimum method of treatment. Review of the records of the Mayo Clinic from 1956 through 1978 revealed that 14 patients had a fracture in the amputation stump and 2 patients had two separate episodes of fracture, for a total of 16 fractures. Each patient's history and the available x-ray films were carefully reviewed. Fifteen fractures involved the femur or hip, and one involved the tibia and fibula. All fractures went on to union, but four of nine treated with internal fixation had comp]lications, three of which required further surgical procedures. At least five fractures in this series might have been prevented by better patient instruction and closer attention to fitting the prosthesis. Half of the fractures resulted from falls in the elderly patient. All five fractures that were treated without internal fixation healed well in a short time. The relatively high complication rate associated with internal fixation contrasted with the relatively rapid rate of union of the fractures treated without internal fixation suggests that these fractures should be treated by conservative measures if possible.
对截肢残端发生骨折的患者进行了一项回顾性研究，以确定如何预防这些损伤，并制定最佳治疗方法。回顾梅奥诊所1956年至1978年的记录发现，14例患者截肢残端发生骨折，2例患者有两次独立的骨折发作，共计16处骨折。仔细查阅了每位患者的病史和现有的X光片。15处骨折累及股骨或髋部，1处累及胫腓骨。所有骨折均愈合，但9例接受内固定治疗的患者中有4例出现并发症，其中3例需要进一步手术。通过更好的患者指导和更密切关注假肢适配，本系列中至少5处骨折可能得以预防。一半的骨折是由老年患者跌倒所致。所有5例未接受内固定治疗的骨折在短时间内愈合良好。与未接受内固定治疗的骨折相对较快的愈合速度相比，内固定相关的相对较高并发症发生率表明，这些骨折如果可能应采用保守治疗措施。
